胃肠道间质瘤(GISTs)的最新进展,重点关注胃肠道外间质瘤(EGISTs)。

An update on gastrointestinal stromal tumors (GISTs) with a focus on extragastrointestinal stromal tumors (EGISTs).

作者信息

Usama Fatima, Rasikh Rohullah, Hassam Khawaja, Rahman Mansoor, Khalil Ur Rehman Fnu, Khan Iman Waheed, Lau Daryl T-Y

机构信息

Internal Medicine Department, Yale Waterbury, Waterbury, CT, USA.

Liver Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

出版信息

Gastroenterol Rep (Oxf). 2025 Jul 23;13:goaf068. doi: 10.1093/gastro/goaf068. eCollection 2025.

Abstract

Gastrointestinal stromal tumors (GISTs) originate from mesenchymal cells and account for ∼1% of primary malignant tumors in the digestive system. They are diagnosed based on characteristic immunohistochemical staining pattern, including CD117 and DOG1, as well as genetic analysis for mutations in the KIT and platelet-derived growth factor receptor α genes. Extragastrointestinal stromal tumors (EGISTs) share very similar morphology with GISTs but arise outside the gastrointestinal tract. The most common locations for EGISTs are the omentum, mesentery, retroperitoneum, and pancreas, followed by the liver, vagina, and prostate. The mean age of presentation of these tumors is in the sixth decade of life and tumor dimensions at different locations typically range from 7 to 15.8 cm. Most of these tumors are unifocal and of the spindle cell type. GISTs generally have a better prognosis than EGISTs, with cumulative 5-year survival rates of 85% for GISTs and 38%-60.9% for EGISTs. Among EGISTs, omental tumors have higher overall survival than mesenteric or retroperitoneal tumors. Additionally, age of >60 years, male sex, larger tumor size, higher mitotic rate, and nuclear pleomorphism are associated with worse prognosis in EGISTs.

摘要

胃肠道间质瘤(GISTs)起源于间充质细胞,占消化系统原发性恶性肿瘤的1%左右。它们通过特征性免疫组化染色模式进行诊断,包括CD117和DOG1,以及对KIT和血小板衍生生长因子受体α基因的突变进行基因分析。胃肠道外间质瘤(EGISTs)与GISTs具有非常相似的形态,但发生于胃肠道外。EGISTs最常见的部位是大网膜、肠系膜、腹膜后和胰腺,其次是肝脏、阴道和前列腺。这些肿瘤的平均发病年龄在60多岁,不同部位肿瘤大小通常在7至15.8厘米之间。这些肿瘤大多为单灶性,呈梭形细胞型。GISTs的预后通常比EGISTs好,GISTs的5年累积生存率为85%,EGISTs为38%-60.9%。在EGISTs中,大网膜肿瘤的总生存率高于肠系膜或腹膜后肿瘤。此外,年龄>60岁、男性、肿瘤体积较大、有丝分裂率较高和核异型性与EGISTs预后较差有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaaa/12286702/1bbbde08d42c/goaf068f1.jpg

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